title: Ileocecal endometriosis and a diagnosis dilemma: a case report and literature review.
abstract: Bowel endometriosis affects between 3.8% and 37% of women with endometriosis. The evaluation of symptoms and clinical examination are inadequate for an accurate diagnosis of intestinal endometriosis. We describe the case of a 41-year-old woman who presented to our hospital because of six months of recurrent abdominal pain, vomiting and diarrhea, without previous history of bowel disease. Physical examination revealed a palpable 3 cm × 5 cm mass in the right lower quadrant abdomen. Laboratory tests showed slightly elevated levels of CA19-9 and CA125. Small bowel computer tomography scanning revealed an ileocecal mass with bowel wall thickening and luminal narrowing. Small bowel endoscopy identified a deep longitudinal ulcer and mucosal edema in the distal ileum. All these findings supported the diagnosis of Crohn's disease. The patient underwent a laparotomy, which identified a 5 cm × 5 cm ileocecal mass with severe mucosal edema and luminal stricture in the distal ileum. Histopathological examination confirmed a diagnosis of ileocecal endometriosis without other areas involved. After one-year follow-up, there was no recurrence of the symptoms.
authors.affiliation: Department of Gastroenterology, Hangzhou Binjiang Hospital, the 2 Affiliated Hospital of Zhejiang University-Binjiang Branch, School of Medicine, Hangzhou 310000, Zhejiang Province, China.
authors.forename: Yu-Ling
authors.initials: YL
authors.lastname: Tong
authors.forename: Yan
authors.initials: Y
authors.lastname: Chen
authors.forename: Shen-Yi
authors.initials: SY
authors.lastname: Zhu
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D001706:Biopsy; D018394:CA-125 Antigen / Q000097:blood; D018395:CA-19-9 Antigen / Q000097:blood; D002429:Cecal Diseases / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D003424:Crohn Disease / Q000175:diagnosis; D003937:Diagnosis, Differential; D003967:Diarrhea / Q000209:etiology; D004715:Endometriosis / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D045823:Ileus / Q000209:etiology; D008565:Membrane Proteins / Q000097:blood; D011237:Predictive Value of Tests; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014839:Vomiting / Q000209:etiology
chemical_list: D018394:CA-125 Antigen; D018395:CA-19-9 Antigen; C451759:MUC16 protein, human; D008565:Membrane Proteins
keywords: Bowel obstruction; Crohn’s disease; Endometriosis; Ileus; Longitudinal ulcer